Data capture and routing system and method

ABSTRACT

A computer system for routing breathing apparatus compliance data that includes a processor and network interface configured to receive input data including breathing apparatus compliance data via a network, format the compliance data into a destination format in accordance with formatting data and transmit the formatted compliance data via a network to a recipient system in accordance with routing information.

INCORPORATION BY REFERENCE TO ANY PRIORITY APPLICATIONS

Any and all application for which a foreign or domestic priority claimis identified in the Application Data Sheet as filed with the presentapplication are hereby incorporated by reference under 37 C.F.R. § 1.57.

FIELD

The present disclosure relates to a system and method for capturingcompliance data from a breathing apparatus and routing that data to adestination for further use.

BACKGROUND

Breathing assistance apparatus are used for a variety of purposes,including PAP, oxygen treatment and the like. When using such apparatusto treat a condition, it is important that the patient complies with thetreatment prescription provided by their healthcare professional. Ifthey do not comply with the treatment prescription (such as not usingthe apparatus in accordance with the healthcare professionals direction)then the treatment may not be successful. Compliance of the patient totheir prescription is of interest to insurance providers who fund theapparatus and treatment, and also the dealers who provide the apparatusto patients.

Breathing apparatus can record compliance data for analysis so thatpatient compliance can be monitored and actions taken if necessary. Thecompliance data is normally obtained from sensors and other processorsin the apparatus itself. The data is then provided to the healthcareprofessional, dealer, insurance provider or other interested party forreview. The provision of compliance data requires some action from thepatient themselves. Many patients have difficulties in ensuring theytake the required actions to transmit the compliance data. This is dueto a number of factors, including inability to use the technology, lackof awareness, forgetfulness, and/or lack of interest.

SUMMARY

It is an object of the present disclosure to provide a system thatassists the provision of data from a breathing apparatus to aninterested party for review.

In one aspect the present invention may be said to consist in a computersystem for routing breathing apparatus usage data to a target recipientsystem of a plurality of recipient systems comprising: a processor andnetwork interface configured to: receive input data comprising breathingapparatus usage data via a network, format the usage data into adestination format in accordance with formatting data, and routing theformatted usage data via a network to the target recipient system usingrouting information.

In another aspect the present invention may be said to consist in amethod of routing breathing apparatus usage data to a target recipientsystem of a plurality of recipient systems comprising: receiving inputdata comprising breathing apparatus usage data via a network, formattingthe breathing apparatus usage data into a destination format usingformatting information, and routing the formatted usage data via anetwork to the target computer system using routing information.

In another aspect the present invention may be said to consist in acomputer system for routing breathing apparatus usage data comprising: aprocessor and network interface configured to: receive input datacomprising breathing apparatus usage data via a network, format theusage data into a destination format in accordance with formatting data,and transmit the formatted usage data via a network to a recipientsystem in accordance with routing information.

Preferably the recipient system is a target recipient system of aplurality of recipient systems and the routing information enablesrouting of the transmitted formatted data via the network to the targetrecipient system.

Preferably the input data further comprises the routing informationand/or formatting information.

Preferably the input data is received directly or indirectly from thebreathing apparatus via one or more of:

-   -   GSM transmission from the breathing apparatus to the computer        system,    -   Mobile/landline telephone transmission from the breathing        apparatus to a PC or to the computer system,    -   VOIP transmission, using e.g. a VOIP handset to a PC or to the        computer system    -   Analogue or digital telephone modem from the breathing apparatus        to a PC or to the computer system,    -   WIFI transmission from the breathing apparatus to a PC or over a        network to the computer system,    -   Ethernet transmission from the breathing apparatus to a PC or        over a network to the computer system,    -   Removable memory device to transfer data between the breathing        apparatus and a PC,    -   Removable memory device to transfer data between the breathing        apparatus to a kiosk connected to the computer system or a        recipient system,    -   Manual input of data displayed on the breathing apparatus into a        PC or website,    -   Manual/voice input of data displayed on the breathing apparatus        into a mobile, landline or VOIP telephone to a PC or the        computer system,    -   Bluetooth™/Zigbee™ transmission from the breathing apparatus        using a home hub or other network connected device to a PC or        the computer system,    -   Bluetooth™ transmission from the breathing apparatus to a mobile        telecommunication device to a PC or the computer system.    -   Data in audible form output from a speaker in the breathing        apparatus over a mobile, landline or VOIP        handset/telecommunications device to a PC or the computer        system.

Preferably the routing information takes the form of one or more of:

-   -   client ID based routing rules,    -   device based routing rules,    -   default routing rules.

Preferably the data originates from one of a plurality of breathingapparatus.

Preferably the usage data is compliance data.

Preferably each recipient system is operated by or on behalf of aservice provider and/or an interested party being one or more of a:

-   -   insurance company,    -   medical equipment dealer,    -   healthcare professional, and/or    -   patient

Preferably each recipient computer system comprises one or more of adatabase, reporting tool and/or user terminal being operated by or onbehalf of a service provider and/or one or more interested parties.

In another aspect the present invention may be said to consist in amethod of routing breathing apparatus usage data comprising: receivinginput data comprising breathing apparatus usage data via a network,formatting the breathing apparatus usage data into a destination formatusing formatting information, and transmitting the formatted usage datavia a network to a recipient system in accordance with routinginformation.

Preferably the recipient system is a target recipient system of aplurality of recipient systems and the routing information enablesrouting of the transmitted formatted data via the network to the targetrecipient system.

Preferably the input data further comprises the routing informationand/or formatting information.

Preferably the input data is received directly or indirectly from thebreathing apparatus via one or more of:

-   -   GSM transmission from the breathing apparatus to the computer        system,    -   Mobile/landline telephone transmission from the breathing        apparatus to a PC or to the computer system,    -   VOIP transmission, using e.g. a VOIP handset to a PC or to the        computer system    -   Analogue or digital telephone modem from the breathing apparatus        to a PC or to the computer system,    -   WIFI transmission from the breathing apparatus to a PC or over a        network to the computer system,    -   Ethernet transmission from the breathing apparatus to a PC or        over a network to the computer system,    -   Removable memory device to transfer data between the breathing        apparatus and a PC,    -   Removable memory device to transfer data between the breathing        apparatus to a kiosk connected to the computer system or a        recipient system,    -   Manual input of data displayed on the breathing apparatus into a        PC or web site,    -   Manual/voice input of data displayed on the breathing apparatus        into a mobile, landline or VOIP telephone to a PC or the        computer system,    -   Bluetooth™/Zigbee™ transmission from the breathing apparatus        using a home hub or other networked device to a PC or the        computer system,    -   Bluetooth™ transmission from the breathing apparatus to a mobile        telecommunication device to a PC or the computer system.    -   Data in audible form output from a speaker in the breathing        apparatus over a mobile, landline or VOIP        handset/telecommunications device to a PC or the computer        system.

Preferably the routing information takes the form of one or more of:

-   -   client ID based routing rules,    -   device based routing rules,    -   default routing rules.

Preferably the data originates from one of a plurality of breathingapparatus.

Preferably the usage data is compliance data.

Preferably each recipient system is operated by or on behalf of aservice provider and/or an interested party being one or more of a:

-   -   insurance company,    -   medical equipment dealer,    -   healthcare professional, and/or    -   patient

Preferably each recipient system comprises one or more of a database,reporting tool and/or user terminal being operated by or on behalf of aservice provider and/or one or more interested parties.

In another aspect the present invention may be said to consist in abreathing apparatus usage data capture system at least one user computercomprising: a device interface for receiving a memory device containingusage data, a processor configured to automatically execute anapplication that retrieves usage data from a memory device via theinterface when the memory device is connected to the device interface,and a network interface to transmit the usage data across a network, anda computer system comprising a network interface and processorconfigured to: receive data from and/or transmit data to the usercomputer via a network, and transmit data to the user computer tocommunicate a reminder for the user to connect the memory device to thedevice interface.

Preferably the application is stored on the memory device.

Preferably the application is downloaded from a webserver and isexecuted upon the user accessing a website provided by the webserver.

Preferably the memory device is a portable device such as a USB memorydevice.

Preferably the reminder is communicated by way of:

-   -   telephone    -   facsimile    -   email/instant messaging    -   text message    -   the internet    -   user IO on the breathing apparatus.

In another aspect the present invention may be said to consist in amethod of routing breathing apparatus usage data: providing anapplication that automatically executes on a user computer to retrieveusage data from a memory device via the interface when the memory deviceis connected to the device interface, and transmits the usage dataacross a network, and providing a computer system comprising a networkinterface and processor configured to: receive data from and/or transmitdata to the user computer via a network, and transmit data to the usercomputer to communicate a reminder for the user to connect the memorydevice to the device interface.

Preferably the application is stored on the memory device.

Preferably the application is downloaded from a webserver and isexecuted upon the user accessing a website provided by the webserver.

Preferably the memory device is a portable device such as a USB memorydevice.

In another aspect the present invention may be said to consist in amethod of capturing usage data comprising: receiving a memory devicecontaining usage data at device interface of a user computer,automatically executing an application on the user computer thatretrieves usage data from the memory device transmitting the usage datato a computer system, and transmitting data from the computer system tothe user computer to communicate a reminder for the user to connect thememory device to the device interface.

Preferably the application is stored on the memory device.

Preferably the application is downloaded from a web server and isexecuted upon the user accessing a website provided by the web server.

Preferably the memory device is a portable device such as a USB memorydevice.

Preferably the reminder is generated based on the time elapsed since thelast usage data upload.

Preferably the reminder is communicated by way of:

-   -   telephone    -   facsimile    -   email/instant messaging    -   text message    -   the internet    -   user IO on the breathing apparatus.

In another aspect the present invention may be said to consist in acomputer system for routing breathing apparatus compliance datacomprising: a processor and network interface configured to: receiveinput data comprising breathing apparatus compliance data via a network,format the compliance data into a destination format in accordance withformatting data, and transmit the formatted compliance data via anetwork to a recipient system in accordance with routing information.

In another aspect the present invention may be said to consist in amethod of routing breathing apparatus compliance data comprising:receiving input data comprising breathing apparatus usage data via anetwork, formatting the breathing apparatus compliance data into adestination format using formatting information, and transmitting theformatted compliance data via a network to a recipient computer systemin accordance with routing information.

In another aspect the present invention may be said to consist in abreathing apparatus compliance data capture system at least one usercomputer comprising: a device interface for receiving a memory devicecontaining compliance data, a processor configured to automaticallyexecute an application that retrieves compliance data from a memorydevice via the interface when the memory device is connected to thedevice interface, and a network interface to transmit the compliancedata across a network, and a computer system comprising a networkinterface and processor configured to: receive data from and/or transmitdata to the user computer via a network, and transmit data to the usercomputer to communicate a reminder for the user to connect the memorydevice to the device interface.

Preferably the application is stored on the memory device.

Preferably the application is downloaded from a webserver and isexecuted upon the user accessing a website provided by the webserver.

Preferably the memory device is a portable device such as a USB memorydevice.

In another aspect the present invention may be said to consist in amethod of routing breathing apparatus compliance data: providing anapplication that automatically executes on a user computer to retrievecompliance data from a memory device via the interface when the memorydevice is connected to the device interface, and transmits thecompliance data across a network, and providing a computer systemcomprising a network interface and processor configured to: receive datafrom and/or transmit data to the user computer via a network, andtransmit data to the user computer to communicate a reminder for theuser to connect the memory device to the device interface.

Preferably the application is stored on the memory device.

Preferably the application is downloaded from a webserver and isexecuted upon the user accessing a website provided by the webserver.

Preferably the memory device is a portable device such as a USB memorydevice.

In another aspect the present invention may be said to consist in amethod of capturing compliance data comprising: receiving a memorydevice containing compliance data at device interface of a usercomputer, automatically executing an application on the user computerthat retrieves compliance data from the memory device transmitting thecompliance data to a computer system, and transmitting data from thecomputer system to the user computer to communicate a reminder for theuser to connect the memory device to the device interface.

Preferably the application is stored on the memory device.

Preferably the application is downloaded from a web server and isexecuted upon the user accessing a website provided by the web server.

Preferably the memory device is a portable device such as a USB memorydevice.

Preferably the reminder is generated based on the time elapsed since thelast compliance data upload.

Preferably the reminder is provided by way of:

-   -   telephone    -   facsimile    -   email/instant messaging    -   text message    -   the internet    -   user IO on the breathing apparatus.

In this specification where reference has been made to patentspecifications, other external documents, or other sources ofinformation, this is generally for the purpose of providing a contextfor discussing the features of the disclosure. Unless specificallystated otherwise, reference to such external documents is not to beconstrued as an admission that such documents, or such sources ofinformation, in any jurisdiction, are prior art, or form part of thecommon general knowledge in the art.

The term “comprising” as used in this specification means “consisting atleast in part of”. When interpreting each statement in thisspecification that includes the term “comprising”, features other thanthat or those prefaced by the term may also be present. Related termssuch as “comprise” and “comprises” are to be interpreted in the samemanner.

To those skilled in the art to which the invention relates, many changesin construction and widely differing embodiments and applications of theinvention will suggest themselves without departing from the scope ofthe invention as defined in the appended claims. The disclosures and thedescriptions herein are purely illustrative and are not intended to bein any sense limiting.

Where specific integers are mentioned herein which have knownequivalents in the art to which this invention relates, such knownequivalents are deemed to be incorporated herein as if individually setforth.

The invention consists in the foregoing and also envisages constructionsof which the following gives examples only.

BRIEF DESCRIPTION OF THE DRAWINGS

Embodiments of the disclosure will be described with reference to thefollowing drawings of which:

FIG. 1 shows an overview of a system for obtaining and forwardingbreathing apparatus compliance data,

FIG. 2 a shows the system in more detail,

FIG. 2 b shows the reporting server in more detail,

FIG. 3 shows a flow chart of the operation of the system,

FIG. 4 shows a CPAP breathing apparatus,

FIG. 5 shows the controller in more detail,

FIG. 6 shows a user computer displaying a browser and auto-executedapplication,

FIG. 7 is a flow diagram showing a method for capturing/sending data viaa memory device,

FIG. 8 is a flow diagram showing an alternative method forcapturing/sending data,

FIG. 9 shows the remote computer system with router functionality,

FIGS. 10 a, 10 b are a flow diagrams showing routing of complianceinformation to different interested parties,

FIG. 11 is a flow diagram showing the reminder server operation.

DETAILED DESCRIPTION

Overview of System

FIG. 1 shows a system 10 that provides for compliance data transfer.Embodiments of the present invention form at least part of the system.Briefly, the system provides for the transfer of information comprisingusage/therapy data (such as compliance and other efficacy and patientdata that shown in table 1 below) and other data from a patientbreathing apparatus 11, such as a CPAP apparatus, to a remote computersystem 15 with routing functionality for reformatting and routing ontoone or more recipient computer systems (also termed “destinationcomputer systems”) 18 for reporting and analysis purposes for interestedparties (also termed “recipients” or alternatively “clients”). It willbe appreciated that the term “compliance data” used through thespecification could be extrapolated to cover any usage/therapy data(such as efficacy data) and mention in the embodiments described of“compliance data” should not be considered limiting.

Interested parties can be insurance companies, dealers and healthprofessionals, for example. The information can be passed directly fromthe breathing apparatus 11 over a communications channel and WAN network12 to the computer system 15, or it can be passed to a PC computer(shown in FIG. 2 a ) or other user apparatus for subsequent transferover a WAN network to the computer system 15. The computer system 15includes a router/router functionality that reformats and routes theinformation to the recipient computer system 18. A reminder server(shown in FIG. 2 a ) is also provided, that provides reminders to a uservia the PC and/or breathing apparatus to upload compliance data andother usage/therapy data. A service provider manages/facilitates andoperates part or all of the system overall system 10.

The overall system and its operation will now be described in moredetail with reference to FIG. 2 a and the flow chart in FIG. 3 . Eachpatient has a breathing apparatus at their residence 11. The remainingdescription will refer to the breathing apparatus as a CPAP apparatus byway of example—this should not be considered limiting. The apparatuscould be any PAP or other breathing apparatus. The patient preferablywill also have a computer 13, such as a PC, at their residence (orelsewhere if using e.g. GSM transmission) which is connected to a widearea network (WAN) 12, such as the internet, via a suitable connection.The CPAP apparatus 11 can be directly or indirectly in communicationwith the WAN 12 via a wireless or wired connection 21, 22. For example,it could be in communication with the WAN 12 via an wired or wirelessexternal or internal modem 23, 24 or other interface using the standardtelephone line or a mobile telecommunications network (such as GSM) 21,22. In another alternative, the CPAP apparatus includes an external orinternal transmission device 23, 24 for transmitting the information tothe WAN 12 over a telecommunications network, such as a mobile telephonenetwork 21, 22. Alternatively, another wireless communications system ornetwork could be used to communicate with the WAN. This allows fortransfer of the information from the CPAP machine over the WAN to theremote computer system 15 with router functionality.

Alternatively or additionally, the CPAP apparatus can be directly 25 orindirectly connected to the PC. This also allows for transfer of theinformation from the CPAP over the WAN 12 (via the PC) to the remotecomputer system 15. The CPAP apparatus can communicate with the PC via awired or wireless communication channel 25. Alternatively, the patientcan utilize a removable memory device 27 to transfer the informationbetween the CPAP apparatus 11 and PC 13 by physically coupling thememory device to each apparatus 11, 13 to transfer data. The PC can thentransfer the information over the WAN to the remote computer system 15,via any suitable communication network or system. The CPAP apparatusand/or PC can be arranged to receive reminders or triggers to transferthe data via a suitable medium, or to display those reminders to apatient to remind them to operate the CPAP machine to transfer theinformation. Alternatively, the user can receive such reminders via atelephone, mobile telephone or other communications device 28. In yetanother alternative, the removable memory device 27 could be insertedinto a kiosk 29 or similar, if the user is away from their homecomputer. The kiosk 29 is in communication with the remote computersystem 15 via a telecommunications network/WAN.

In summary, any of the following modes can be used to transferinformation from the CPAP apparatus 11 to the remote computer system 15.

-   -   GSM transmission from CPAP apparatus to remote computer system,        e.g. 23 or 24, 21 or 22 or 25,    -   Mobile/landline telephone transmission from CPAP apparatus to PC        or to remote computer system e.g. 28.    -   VOIP transmission, using e.g. a VOIP handset e.g. 28.    -   Analogue or digital telephone modem from CPAP apparatus to PC or        to remote computer system e.g. 23 or 24, 21 or 22 or 25.    -   WIFI (or other wireless) transmission from CPAP apparatus to PC        or over network to remote computer system e.g. 23 or 24, 21 or        22 or 25.    -   Ethernet (or other wired) transmission from CPAP apparatus to PC        or over network to remote computer system e.g. 25.    -   Removable memory device to transfer data between CPAP apparatus        and patient PC e.g. 27.    -   Removable memory device to transfer data between CPAP apparatus        to kiosk connected to remote computer system or recipient system        e.g. 27, 29.    -   Manual input of data displayed on CPAP apparatus into a website.    -   Manual/voice input of data displayed on CPAP apparatus into a        mobile, landline or VOIP telephone e.g. 28.    -   Bluetooth™/Zigbee™ transmission from CPAP apparatus using via a        home hub or other network connected device.    -   Bluetooth™ transmission from CPAP apparatus to mobile        telecommunication device.    -   Data in audible form from CPAP apparatus speaker over a mobile,        landline or VOIP handset/telecommunications device to the PC or        remote computer system.

These are just some examples of the transmissions methods, and it willbe appreciated other transmission methods could be envisaged by thoseskilled in the art.

The remote computer system 15 is connected to the WAN 12. As previouslynoted, the computer system can receive data directly from the CPAPapparatus 11 over the WAN 12, or via the user PC 13. The remote computersystem 15 includes router functionality and is operated by either aprovider of the system, an agent of the provider or other third party.The information that the computer system 15 receives includes complianceand other data relating to usage of the CPAP apparatus 11 by thepatient. The information might also comprise routing data indicatingwhere the compliance data should be routed to, and formatting dataspecifying how the compliance data should be formatted for therecipient. Alternatively the routing and/or formatting data could bestored in the remote computer system 15, or received via another source.

The computer system 15 uses the routing and formatting data to reformatthe compliance data and route it to an appropriate recipient computersystem or systems (shown generally as 18 in FIGS. 1 and 2 a) forproviding the reporting/analysis services to interested parties (e.g.insurance companies, dealer, healthcare professionals and/or patient).The recipient computer system 18 usually takes the form of multiplerecipient computer systems e.g. 18 a-18 d, each for storing andreporting clinical information for different interested parties. Eachrecipient computer system e.g. 18 a-18 d (hereinafter: simply referredto as the recipient computer system 18) includes a database that storesthe reformatted and routed compliance data and other information, and aserver that provides reporting services/tools for presenting the reportsand information to the interested parties (e.g. dealer, healthcareprofessional, insurance provider, and/or patient.) The server anddatabase for each can be located remotely from each other or in the samelocation. Reporting services/tools comprise software tools forpresenting reports and information on clinical information in relationto a patient to the interested parties. The reporting tools/services canbe accessed by individuals in an interested party through a PC connectedto the report server via a network. This enables those interestedparties to review and understand information pertaining to each patientand their use of the CPAP machine.

Each recipient computer system 18 might be operated by the interestedparties or a third party or the system provider. Each recipient computersystem is for a different interested party. Each recipient computersystem 18 can be configured/operated in various ways, depending on therequirements of the interested parties, examples of differentconfigurations are labelled 18 a-18 d in FIG. 2 a . A party might fullyor partially operate the recipient computer system themselves, orcommission a third party to fully or partially operate the recipientsystem on their behalf. A number of different configurations/options arepossible. Some parties want to retain full control of the informationand reporting services. Others will allow the information to be storedand controlled by another party and/or allow the reporting services tobe provided by another party, such as the service provider. Any one ormore of the configurations could form part of the overall system, eachrecipient computer system configuration being for use by one of the manyinterested parties that will use the overall system.

In one embodiment, the recipient computer system 18 is a server 19 aoperated by or on behalf of the service provider for providing reportingservices to the interested party 18 a. In this embodiment, the databasee.g. 30 a/203 resides with the server 19 a (as shown in FIG. 2 a , or isremote but in communication with the server 19 a). The server 19 a withdatabase 30 a/203 is shown in more detail in FIG. 2 b . The server 19 aprovides report tools (e.g. the user interface (UI) viewer 31 a). Theserver 19 a comprises a network interface 200 for receiving informationrouted from the remote computer system 15. The information is passed toan input data processor 201 and on to a server controller 202. Theserver controller 202 manages the data domain, processes commands andrequests with respect to the data domain. Command and query handlers 204provide reporting tools for reporting the output via the networkinterface 200. The server 19 a comprises or is in remote communicationwith the database 203 that stores the relevant information (that is, thereformatted routed compliance data and other information) for theinterested parties and is passed to the server that provides thereporting tools 31 a. In one variation, the server provides aclient/server software solution reporting tool 31 a that resides on theserver 19 a (or elsewhere) and on the interested party's computers (e.g.PC/desktop computer). The interested party (which comprises individualsfrom the interested party) can access the information via a softwarereporting tool on their computer 32 a (which has a Graphical UserInterface (GUI) 33 a), which obtains the information from the server 19a, over a WAN such as the internet. In another variation, the server 19a is a web server that provides web-based reporting tools. Theinterested party can access the information via a browser on theircomputer 32 a, which obtains the information from the web server overthe internet. In this embodiment, the service provider provides thereporting client/viewer 31 a.

In yet a further variation 18 c a third party can access the database203 and server 19 a, but provide their own reporting user interfaces andtools (UI report viewer or report client) 31 c. Interested parties canaccess relevant information on their PC 32 c (through a GUI 33 c) viathe third party user interfaces/reporting tools 31 c, rather than usingthose provided by the service provider as was indicated in the exampleof the server 19 a. In yet a further alternative 18 c, the interestedparty provides their own reporting user interfaces and tools (UI reportviewer or report client) 31 c. Interested parties can access relevantinformation using their user interfaces, rather than using thoseprovided by the service provider.

In another embodiment 18 d, the recipient computer system is a serveroperated by or on behalf of interested party for providing reportingservices to the interested party. In this embodiment, the database 30 dresides along with the server 18 d. The server 18 d with database 30 dis the same or similar to 203/30 a previously shown and described withrespect to FIG. 2 a . The server 18 d comprises (or remotelycommunicates with) the database 30 d that stores the relevantinformation (that is, the reformatted routed compliance data and otherinformation) for the interested parties and is passed to the server 31 dthat provides the reporting tools 31 d. The interested party providestheir own reporting user interfaces and tools (report viewer or reportclient) 31 d. Interested parties can access relevant information usingtheir user interfaces 31 d using PCS 32 d with GUIs 33 d, rather thanusing those provided by the service provider. In a variation, theservice provider provides the reporting client/viewer.

In another embodiment, the recipient computer system 18 b is a server 19a operated by or on behalf of the service provider. However, using anAPI, the interested party can retrieve the information into a localsystem 18 b (such as an electronic medical record (EMR)/patientmanagement system database) 34 b for use and reporting via that systemthrough a PC 32 b and GUI 33 b. Integration into an online EMR couldalso occur. The local system 18 b is operated by or on behalf of theinterested party.

Various other configures/architectures of recipient computer systemscould also be envisaged and the invention is not limited to thosedescribed above.

The various embodiments of recipient computer systems 18 a-18 d allowfor the following:

-   -   the service provider to host all data and provide all reporting,    -   the interested party to host all data and provide all reporting,        or    -   a mix between the service provider hosting data/providing        reporting and the interested party hosting data/providing        reporting.

The system 10 also has a reminder 150 server that generates and providesfor reminders so that a patient is prompted to operate their computerand/or CPAP apparatus 11 to transfer data comprising compliance data tothe remote computer system/router 15. This could be hosted by anysuitable party and for exemplary purposes is shown coupled to thedatabase of the 30 a hosted by the service provider.

FIGS. 1 and 2 show only one PC and CPAP apparatus, however it will beappreciated that the system is arranged to receive data, includingcompliance and other usage/therapy data from a plurality of patient CPAPmachines in various locations, and reformat and route that data to theappropriate database/server (recipient computer system) for providingreporting services (either operated by or on behalf of the interestedparty or the provider) for a range of interested parties. It will alsobe appreciated that the various embodiments do not necessarily need tocomprise every component shown in FIGS. 1 and 2 a. FIGS. 1 and 2 a showpossible options, of which some or all might be present. Some componentsof the system such as the breathing apparatus, user computer and thirdparty computer systems can be considered optional for connection to thesystem, but not an integral part thereof.

The operation of the system will be briefly described with reference toFIG. 3 . A reminder to upload data to the computer system can optionallybe sent to the user, step 40. Upon reminding, or of their own accord,the user can effect upload of compliance and other usage/therapy data tothe remote computer system 15 via any one of the modes described above.Alternatively, the CPAP apparatus and/or PC automatically upload thecompliance data. The compliance data is received by the computer system,step 41. The computer system 15 reformats and routes the compliance datato the recipient's computer system 18, based on reformatting and routingdata, step 42. The compliance data is stored on the recipient computersystem database, step 43, then transferred to the recipient's reportingserver (which may encompass the database), step 44. The recipient reportserver then provides reporting services to the recipient, step 45.

Detailed Description of Components and Operations of the System

The configuration and operation of aspects of the system will now bedescribed in further detail

Breathing Apparatus

FIG. 4 is a block diagram illustrating one embodiment of a breathinggases supply system 1 that might be used in the system of FIG. 1 . Thefull system includes a PAP apparatus 100 for delivering a supply ofbreathing gases, a breathing circuit 101 and a patient interface 102.

The supply conduit 101 extends from an outlet in the PAP apparatus 100and to the patient interface 102. The patient interface may be anysuitable sealing patient interface such as a full face mask, nasal mask,nasal pillows, oro-nasal mask, oral mask, oral interface, nasal seal,nasal cannula and so on.

The PAP apparatus 100 includes a blower. The blower preferably includesa fan 103 driven by an electric motor 105. Air is drawn into the PAPapparatus 100 through the inlet 104 by the fan 103. Pressurised airleaves the fan 103 for supply to the patient. Alternatively,controllable flow generators may draw on a source of high pressure gas,and regulate a flow of gas from the high pressure source.

The PAP apparatus 100 preferably includes a humidifier 115 in theembodiment of FIG. 1 . In alternative embodiments the humidifier 115 maybe separate from the PAP apparatus and part of the breathing gasessupply system 1 or alternatively there may be no humidifier 115 present.The humidifier 115 as shown in FIG. 1 is a pass over type humidifierwhere air passing through the humidifier picks up a quantity of watervapour from a reservoir of water 107. The water reservoir 107 may beheater by a heater 108. The humidifier 115 is preferably integrated intothe housing of the PAP apparatus 100. Alternatively the humidifier 115may be a separate component within the housing of the PAP apparatus orseparate from the PAP apparatus 100 with a conduit connecting betweenthe PAP apparatus 100 and the humidifier 115. Other types ofhumidifiers, other than a pass over type may be used. In some forms orembodiments multiple humidifiers may used in the breathing gases supplysystem 1.

The heater 108 and the motor 105 are supplied by a power supply (PS)106. The amount of power supplied to the motor determines the speed thefan 103 turns at. The amount of power supplied to the heater 108determines the amount of water vapour produced by the humidifier 115 andhence is one way of controlling the amount of humidification of thebreathing gases supplied by the PAP apparatus 100. The amount of powersupplied by the power supply 106 is controlled by the outputs of acontroller.

The PAP apparatus preferably includes a first controller 109. The firstcontroller 109 preferably is used to control the blower and breathingcircuit. The controller 109 is supplied by power from the power supply106. The controller receives inputs from a user interface (UI) 113. Theuser interface could be in the form of any suitable user interface suchas a knob, a plurality of buttons, a screen or any combination thereof.The user interface 113 allows the PAP apparatus 100 to displayinformation to the user and also allows a user to input information tothe PAP apparatus, more particularly to the controller 109. Thecontroller 109 may also be provided with an interface 114 for connectingto an external data source. The external data source may for example, bea communication interface such as a modem, or may be an interface to anexternal memory such as a smart card, USB, flash drive, disk drive orthe like. The interface is capable of connection with a mobile storagedevice. For generic use, the interface 114 may be a data communicationsport according to any available standards for example a universal serialbus (USB) port. The interface 114 may also be capable of wirelesscommunications such as Bluetooth, infrared and the like. The interface114 may also be capable for connecting to a wide range of peripheraldevices.

The controller 109 typically includes an embedded microcomputer withstored control programs for controlling various aspects of the PAPapparatus 100 and operation of these aspects. Alternatively thecontroller 109 may be removable from the PAP apparatus 100. In a furtheralternative form the controller 109 may be remote to the PAP apparatus100.

The controller 109 preferably includes interfaces for receiving inputsfrom a user interface 113 and for receiving inputs from one or moresensors which preferably comprise a flow sensor 110, a pressure sensor111 downstream to the fan and a flow sensor 112 that is placed close toor on the patient interface to determine the flow or velocity of gasessupplied to the patient or user. The flow sensor 110 may be positionedupstream or downstream to the fan 103. The sensors are one configurationof sensors that can be used in the breathing gases supply system 1. Anyother configuration of sensors and any other types of sensors may beused. There may be fewer or more sensors than those shown. There may avariety of other sensors that measure other data such as humiditysensors, mass flow sensors, temperature sensors and the like.

In the embodiment shown, the breathing gases supply system 1 includes atleast a flow sensor 110 and pressure sensor 111 in the PAP apparatus 100and a flow sensor 112 adjacent the patient interface 102. The datameasured by the sensors, i.e. flow and pressure, will be referred to asbreathing data because it signifies data that relates to the breathingof the patient. The two common variables measured are pressure and flowof gases breathed or supplied to the patient or user.

The apparatus also includes an interface for receiving a removablememory device (such as a USB storage device). The interface is coupledto the processor such that information can be uploaded to the processorfrom the removable memory device, and downloaded to the removable memorydevice from the processor.

FIG. 5 shows the controller and sensors in more detail. Parameters aremeasured by flow, pressure and any other suitable sensors 111, 112attached to the CPAP apparatus 11 and the information is passed asdata/signals to the controller 109. The information can be processed byalgorithms 50 in the controller that determine compliance and efficacyinformation from these signals, as known by those skilled in the art,and stored in internal storage 52. Some or all of the followinginformation is derived: flow, mask leaks, min/max pressures, averagepressures, 90^(th) percentile pressures, AI, HI, awakenings, apneaevents, hypopnea events, flow limitation events. This information isstored as data in the breathing apparatus internal memory for each usagesession. Two types of data are stored, summary and detailed data, eachin a different data table.

An example summary usage data is shown in the table below that includesusage time, compliance time (compliance data), AI, HI, 90^(th)percentile pressure, average pressure, 90^(th) percentile leak, averageleak and awakenings for a usage session (efficacy data), one of thesetable entries is created each usage session.

TABLE 1 usage 90^(th) 90^(th) Session time Compliance percenttileaverage percentile average Date/Time (hh:mm) time AI HI pressurepressure leak leak awakenings Session #1 5:50 4:15 5 7 12.0 10.0 40 30 5Jan. 1, 2011 10:54:00

An example of detailed usage data is shown below that includes, leak,pressure, apnea events, hypopnea events, flow limitation events andawakenings, one of these entries is created every two minutes within ausage session.

TABLE 2 Flow Apnea Hypopnea limitation Awak- Sample Pressure Leak eventEvent event ening 2 minutes 10 43 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 1 4 minutes 10.2 44 6 minutes 10.1 43 8 minutes 10.2 42

When a usage session ends or a removable memory device is connected tothe breathing apparatus, the controller 109 will synchronise anyinternally stored data, not yet on the memory device, to the removablememory device. To do this, the controller has an internalstorage/external USB storage synchronisation function/area 51 whichstores a last session synchronised marker internally, and compares thismarker to the latest session logged. If there is summary usage sessiondata to be synchronised in the internal summary table, these entries arecopied by the controller, to a summary file on the memory device. If nosummary file exists, one is created by the controller. If there isdetailed usage data to be synchronised in the internal detailed datatable, these entries are copied by the controller, to a detailed file onthe USB storage device. If no detailed file exists one is created by thecontroller. The files are created with a fixed size and when one fillsup, another is created. The files exist within a FAT32 file system onthe USB storage device. Synchronisation occurs as set out by devicesettings 53.

In order to correlate detailed data table entries to a usage session anindex table exists that stores the session date, time and the first rowof data in the detailed table for that session and the number of rows ofdata in the detailed table that are included in that session. An entryis created every usage session. An example of an entry is shown in thetable below.

TABLE 3 Detailed Table Rows in Date/Time row start index session Jan. 1,2011 1 100 10:54:00 Feb. 1, 2011 101 43 11:23:00

A detailed file on the removable memory device contains a headerdescribing the file type, device serial number and device model, theindex table, followed by the detailed data table.

After download, the removable memory device holds the information in thedetailed and the summary tables. This includes compliance data, which isbroadly used to mean any information relating to compliance, or formwhich compliance can be determined. Other information can be storedalso—such as efficacy data or other usage/therapy data. References tocompliance data will be used to cover any type of information relatingto operation of the breathing apparatus.

Data Transmitting Components and Operation

Periodically or in an ad hoc manner, and either automatically or uponaction by the patient, either with or without a reminder, informationthat includes the compliance data that the CPAP apparatus has obtainedis transferred across the WAN and received by the remote computer system15, step 41 in FIG. 3 . Where transfer is made upon action by thepatient, this might be in response to a reminder provided by the system,in a manner to be described later. Optionally, routing data andformatting data is also transferred to the remote computer system 15from the CPAP apparatus (although this might already exist on the remotecomputer system 15). The information is transferred in one of severalways. In any of these alternatives, where user intervention is required,the user can receive a reminder to take action to ensure transfer of theinformation occurs. The reminder system will be discussed in detaillater.

Referring to FIG. 6 , various alternatives of data transfer aredescribed. In a first alternative the CPAP apparatus 11 includes or isconnected to an internal or external modem or other interface thatconnects the CPAP apparatus wirelessly or wired to the WAN. In anotheralternative, the CPAP apparatus includes an external or internaltransmission device for transmitting the information to the WAN over atelecommunications network, such as a mobile telephone network. Inanother alternative, the CPAP apparatus can be connected to the PC,either wirelessly or through a suitable connection, to transfer the datato the centralised computer system via the PC. In another alternativethe CPAP apparatus can be directly connected to the WAN through apatient home connection such as WIFI™, Ethernet™ or Zigbee™. Yet furtheralternatives are possible, as previously mentioned.

In any of the above communication alternatives, download of thecompliance data from the CPAP machine across the WAN to the computersystem 15 can be triggered by user action (such as activating a control)or automatically by the CPAP machine. For example, in one variation,when a treatment session ends or at a scheduled time the modem or othertransmission interface is signalled, and initiates a download of thecompliance data from any previous sessions to the computer system 15 andalso stores this information internally. The modem or other interfacemay also receive a settings update from the computer system 15 at thattime and is able to apply this update to the modem, interface or CPAPmachine. If a settings update is received and applied, the modemconnects a second time to confirm the newly applied settings with theremote service.

In yet another alternative, the information can be transferred via thePC to the WAN by the patient or other user using a removable memorydevice. The removable memory device is inserted into the CPAP machine toreceive the information (compliance data), and then transferred and theinserted into the computer. The information is then uploaded to thecomputer and uploaded to the remote computer system 15 via the WAN fromthe PC through its connection to that WAN. Again, this action can becarried out after the user is prompted for example by a message on thecomputer or on the CPAP machine.

In yet another alternative, the patient is issued with a removablememory device for use with the CPAP apparatus. This can store data fromthe CPAP apparatus, and can comprise client ID information, deviceinformation and/or a download application—as will be described later.When a removable memory device is inserted into the interface of theCPAP apparatus, the removable memory device synchronises any internallystored data and begins recording new data to the memory stick. As partof this, compliance data is transferred to it either automatically orupon prompting by the user. The PC also has a port, into which thememory device is inserted and the compliance data is uploaded to the PC.

Upload to the PC, and subsequent transfer to the centralised computersystem 15 can take place upon the user operating suitable software onthe PC and/or memory device to facilitate this task. However, in apreferred alternative, the upload and transfer application resides onthe removable memory device and activates automatically. The PC containsa memory device detection application. When the application detects thatthe removable memory device has been inserted into the PC, the uploadand transfer application on the memory device is automatically executed,and uploads the data to the PC and facilitates the transfer of that datavia the PC/WAN to the centralised computer system. This simplifies theprocess for the patient, making it more likely that transfer of the datawill occur. As an option, the upload application prompts the patient toenter their date of birth or other information as a security checkbefore connecting to and sending the compliance data contained on thememory device to the computer system 15.

FIG. 7 shows a flow diagram setting out the method for transferringinformation using a removable memory device. This shows in more detailwhat occurs between steps 40 and 41 of FIG. 3 when transfer occurs via aremovable memory device. The user of their own accord, or upon receivinga reminder through the PC or CPAP apparatus, step 40, plugs the movablememory device into the port of the CPAP apparatus (if not alreadyinstalled). For example, the patient could receive the reminder as anautomated reminder phone call, text, email, message via the PC, CPAPapparatus and/or communications device to remind them to insert theirmemory stick into their PC to upload the data. Once the memory device isreceived in the port, step 71, the CPAP apparatus then downloads theinformation to the memory device, step 72, that includes the compliance,routing and formatting data—either automatically, or upon operation ofthe CPAP apparatus by the user.

Once the data is downloaded, the user removes the removable memorydevice and plugs it into the port in the PC, step 73. At this point, inone alternative, when the memory device is received in the port, the PCdetects the removable memory device, step 74 and triggers theapplication on the removable memory device to automatically execute andupload the data to the PC, step 75 and subsequently transfer that datawhich is received at the remote computer system via the WAN, step 41. Todo this, the application on the removable memory device connects to aweb service and prompts the patient to enter their date of birth. Thepatient enters their date of birth, which is sent to the integrationengine and checked against their registered date of birth, if the datesmatch, a message is sent back to the removable memory device applicationto begin the data upload. On receiving the date of birth confirmation,the remote computer system collects any data files on the removablememory device.

Referring to FIG. 6 and to the flow chart in FIG. 8 , an alternativemethod for transfer from the removable memory device is described usingan upload applet is installed on the PC. In this alternative, the PC,upon user activation, can receive or access a web page/web portal via abrowser over the wide area network from the web server. When a useraccesses the website (web portal) of the service provider, they canrequest an upload applet, step 80. This is sent from the web portalserver and downloaded to the PC, step 81. When the user accesses the webportal a subsequent time, the web server receives an access request,step 82, and data is downloaded for rendering the web page and also fortriggering automatic upload of the data using the applet, step 83. Theapplet activates automatic upload of compliance data from the removablememory onto the PC and subsequent transfer across to the centralisedcomputer system, step 84. The applet does this immediately if theremovable memory device is already in the port, otherwise the appletwill await insertion of the removable media device and then transfersthe information over the network to the computer system. This compliancedata is received at the remote computer system, step 41. In yet anotheralternative, if the CPAP apparatus is directly or indirectly connectedto the PC, the data in a memory of the CPAP apparatus can beautomatically uploaded using the applet and transferred. Therefore theupload applet is automatically run on the computer and automaticallytransfers the data, without user intervention. This simplifies theprocess for the patient, making it more likely that transfer of the datawill occur. The upload applet could, for example, be an ActiveX controlthat is downloaded from the website and installed by a user. Uponaccessing the website, the website can interact with the control toautomatic upload information from the CPAP machine to the server andobtain status information

Routing Using the Remote Computer System

FIG. 9 shows the remote computer system 15 in more detail, and FIG. 10 ashows a flow diagram of its operation. In overview, the remote computersystem 15 has a data integration engine service 90 that includes a webservice 91, a data decoding engine 92, a routing engine 93 and one ormore data output engines 94 a, 94 b. The remote computer system 15itself has a network interface 95, storage (which includes a database)96 and a processor 97. In summary, the remote computer system 15 routesthe uploaded information to and customises the information for thedestination computer system. To do this, the data integration enginereceives the information (also termed “input” or “input data”) uploadedfrom the CPAP machine 11 by any suitable method (such as one of thosedescribed above). The data integration engine 90 extracts the compliancedata from the information, reformats the compliance data in accordancewith formatting data for the recipient computer system and then routesthe reformatted data to the appropriate recipient computer system 18.The data integration engine is able to receive information (input data)from data sources (such as a CPAP apparatus) in a variety of formats(such as XML or binary), and format that input data to match therequirements of the recipient computer system 18 before forwarding thedata.

With reference to FIG. 9 and the flow diagram in FIG. 10 a , the remotecomputer system 15 operation will now be described in more detail. Thefunctionality of the data integration engine 90 and remote computersystem 15 generally is operated by the processor 97. Information that isuploaded from the CPAP apparatus 11 is received via the WAN 12 at thenetwork interface 95 and passed to the data decoding engine 92 using theweb service 91, step 130. The data decoding engine 92 decodes theinformation into a common internal data format, step 131, and passesthis to the routing engine 93, step 132. Routing rules are stored in thedatabase 96, which are used by the routing engine 93 to format and routeinformation to the appropriate recipient computer system 15. Routingrules (also termed “routing data” or “routing information”) are used todefine/identify the recipient computer system 18 to which information isto be sent, and to obtain the appropriate output engine to use to senddata to the recipient. The appropriate output engine contains theaddress of the recipient computer system (or the address may be in adatabase on e.g. a routing system). The routing engine 93 looksup/retrieves the appropriate routing rules for the information in thedatabase 96, step 132, and then dispatches the information in the commoninternal data format to a data output engine e.g. 94 a corresponding tothe recipient computer system 18 as indicated by the retrieved routingrules, step 133. Preferably, a separate data output engine e.g. 94 a, 94b exists for each recipient computer system 18 (e.g. 18 a-18 d) to whichinformation is sent. Note, however an output engine might have multiplerecipients.

Each data output engine e.g. 94 a, 94 b includes software modules totransform/encode input data/information from the common data/routingformat into the format required by the recipient computer system 18,step 134. The output engines store formatting data which is providedupon creation of the output engines. Such formats, comprise, for exampleXML, HL7, CSV, ASTM, EDIFACT, HPRIM 2.1, NCPDP, NSF, UB92, X12. Eachdata output engine e.g. 94 a, 94 b can customise information fordelivery and deliver this information using any sort of suitabletransport protocol, such as a web service, ftp, http, e-mail, TCPclient, TCP server, fax or a direct database connection. Each dataoutput engine e.g. 94 a, 94 b has the ability to establishcommunications with a corresponding recipient computer system 18 andtransfer reformatted data to that system. After the data output engineencodes the input data into the recipient computer system format, thedata output engine dispatches the encoded information to the recipientcomputer system via the network interface 95 and WAN, step 135.

The functionality/operation of the routing aspects of the remotecomputer system 15 will now be described with reference to the flowchart in FIG. 10 b , which shows more detail of step 132 of FIG. 10 a .A previously described, routing rules are stored in the database 96,which are used by the routing engine 93 to format and route informationto the appropriate recipient computer system 15. Three types of routingrules are used, these being:

-   -   1) client ID based routing rules,    -   2) device based routing rules, and    -   3) default routing rules.

Note, the routing rules are not mutually exclusive and can be combined.Client ID based routing rules are used to format and route informationto a recipient (also termed “interested party” or “client”) computersystem 18 based on the identification of the recipient (client). Devicebased routing rules are used to format and route information to arecipient computer system 18 based on the CPAP apparatus from which theinformation originated. Default routing rules are used to route andformat information in conjunction to any routing based on the client IDor device ID routing rules. The type of routing rules used will dependon the information uploaded. One or a combination of the three differenttypes of routing rules might be used to identify and dispatch uploadedinformation to one or more recipient computer systems.

Operation based on client ID based routing rules will now be describedin more detail. A client (recipient) is associated with CPAP apparatusused by patients—the client can be associated, for example, by way ofbeing a clinician of the patients, or insurer or dealer providing theCPAP apparatus. Each client (recipient) has a respective recipientcomputer system (e.g. web server with a web services interface) 18, suchas one of those described previously. Client ID based routing rules arestored in a client ID routing table in the database 96, in a format suchas that shown in table 4 below. This table stores client IDs allocatedto recipients (clients) and associated destination identifier for theappropriate output engine corresponding to the recipient computersystems 18 of those recipients. Each client ID and associated outputengine identifier/destination identifier define a routing rule. Theclient ID is a unique alphanumeric identifier associated with a CPAPapparatus that identifies the recipient (client). The destinationidentifier can identify an output engine for a respective recipientcomputer system and/or specify its address. The address for the outputengine associated with a recipient computer system address can be termeda “destination address” or a “recipient address”. The addresses couldtake the form of IP addresses, fax numbers, FTP address, and/or emailaddress, for example. The table might also store formatting informationfor each respective recipient computer system 18.

TABLE 4 Client ID Destination identifier 001 OutputEngine1 023OutputEngine2 123 OutputEngine3 256 OutputEngine1 545 OutputEngine4

When a data source (e.g. CPAP apparatus) connects to the integrationengine to upload information (step 130 FIG. 10 a ) it can optionallyprovide/include a client ID as part of that information. The client IDcould be included in a header, for example. On receiving informationcontaining a client ID (FIG. 10 b , step 136) the data integrationengine 90 retrieves the relevant routing rules for that client ID, steps137, 138, FIG. 10 b . This involves determining if a client ID exists inthe information, step 137, and querying a look up table to retrieve anyoutput engines for recipient computer systems associated with thatclient ID in the database, step 138. The output engine identifier isretrieved for each entry that exists in the table that corresponds tothe client ID. Upon retrieving the routing rules, the routing enginedispatches the information to the appropriate data output engine asidentified in the rule e.g. 94 a, 94 b for the destination, step 133,FIG. 10 a . The data output engine formats the information into asuitable format (such as CSV) according to the formatting informationcontained in the output engine, step 134, FIG. 10 a . The data outputengine then dispatches/routes the formatted information to theidentified recipient computer system 18 using the address/identifier,step 135, FIG. 10 a.

Referring to FIGS. 10 a and 10 b , an example of routing based on clientID rules will be described with reference to table 4. A client(recipient) is assigned a client ID of “123”. Information (in the formof e.g. binary files) is uploaded from one of the CPAP apparatus, step130. In addition to compliance data, the information includes the clientID 123 of the client associated with that CPAP apparatus 11. Informationcould be uploaded in any manner previously described. Upon receiving theinformation at the network interface 95, step 130, it is passed to theweb service 91 and on to the data decoding engine 92. The data decodingengine decodes the binary files into a common internal format (such asXML), step 131, and the data, along with the client ID 123 is thenpassed to the routing engine 93, step 132. When the information reachesthe routing engine, to find the client ID based routing rules, therouting engine accesses the routing rules database 96 and checks to seeif any entries exist for an associated output engine (relating to arecipient computer system) corresponding to the client ID 123, step 138.In this case the output engine is OutputEngine1. The data output enginee.g. 94 a identified receives the information, step 133, and transformsthe information into a suitable format (such as CSV), step 134, usingformatting information, and delivers it to the recipient computer system18 over a SOAP web service, step 135.

Operation based on device (apparatus) based routing rules will now bedescribed in more detail. A patient is issued with a breathing apparatus(e.g. CPAP apparatus) 11 by their health care provider, insurer ordealer and is registered in a patient management system. A routing rulefor a particular CPAP apparatus 11 is then able to be created byregistering the apparatus on the system. Registration involves providinga device serial number and an associated recipient computer systemdestination address to the data integration engine 90, via a web serviceAPI or registration web site. To do this, on registering a patient, aclient's patient management system makes a web service call to the dataintegration engine 11 to register the patient in the system. The callincludes the CPAP apparatus serial number, the patient's date of birth,and a username and password for security. On receiving the call, thedata integration engine 90 validates the username and password, lookingup the destination identifier associated with the username/password froma client table. An entry is then added to the registration routingtable. As a result, the data integration engine 90 stores serial numbersfor each patient CPAP apparatus 11 and associated destinationidentifiers for the data output engine corresponding recipient computersystems 18 of those interested parties who provided the CPAP apparatus.The information is stored in the database 96, in a table such as thatshown in table 5. This information is stored along with correspondingdates of birth for the patients associated with each device. The serialnumbers, along with the respective output engine identifiers formrouting rules. The table might also store formatting information foreach respective recipient computer system 18.

TABLE 5 Serial Number Date of Birth Destination 123456 26 Aug. 1973OutputEngine1 123457 24 Sep. 1968 OutputEngine2 234568 12 Oct. 1959OutputEngine1 232323 1 Jul. 1940 OutputEngine3

Referring to FIGS. 10 a, 10 b , when a data source (e.g. CPAP apparatus)connects to the data integration engine 90 to upload information, it canoptionally provide a serial number as part of that information. Onreceiving information containing a serial number, step 130, the dataintegration engine retrieves the relevant routing rules for that serialnumber, step 132. This involves determining whether the informationcontains a serial no, step 139, and if so, querying a look-up table toretrieve the output engine capable to output data to any recipientcomputer systems 18 associated with that serial number in the database,step 140. The output engine identifier is retrieved for each entry thatexists in the table that corresponds to the serial number. Uponretrieving the routing rules, the routing engine dispatches theinformation to the appropriate data output engine for the destination,step 133. The data output engine, e.g. 94 a, 94 b identified receivesthe information, step 133, and formats/transforms the information into asuitable format (such as CSV) according to the formatting information,step 134. The data output engine then dispatches/routes the formattedinformation to the associated recipient computer system 18, step 135.

An example of routing based on device (apparatus) based routing ruleswill be described with reference to table 5. A CPAP apparatus 11 has theserial number 123456. Information (in the form of e.g. binary files) isuploaded from the CPAP apparatus, step 130. In addition to compliancedata, the information includes the serial number 123456 of that CPAPapparatus. Information could be uploaded in any manner previouslydescribed. Upon receiving the information at the network interface 95,step 130, it is passed to the web service and on to the data decodingengine 92. The data decoding engine decodes the binary files into acommon internal format (such as XML), step 131, and the data, along withthe serial number 123456 is then passed to the routing engine 93, step132. When the information reaches the routing engine, to find the devicebased routing rules, the routing engine accesses the routing rulesdatabase and checks to see if any entries exist for an output enginecorresponding to the serial number 123456, steps 139, 140. In this casethe output engine is OutputEngine1. The data output engine e.g. 94 bidentified receives the information, step 133, and transforms theinformation into a suitable format (such as CSV), step 134, and deliversit to the recipient computer system 18 over a SOAP web service, step135.

Operation based on default routing rules will now be described in moredetail. A default routing rule is a global rule that can be associatedwith one or many destinations, and is able to define a secondarydestination for the data. Default routes allow data for one or manydestinations to also be forwarded on to a second destination. Defaultrouting rules are stored in a default routing table. This table storesthe destination address/identifier and any corresponding alternativedestination(s) in the database 96. These form routing rules.

TABLE 6 Destination Alternate route OutputEngine1 OutputEngine2OutputEngine1 OutputEngine3 OutputEngine4 OutputEngine5 OutputEngine6OutputEngine7

On receiving information the routing engine 93 retrieves routing rulesfor a destination using a client ID or device serial number as describedabove, steps 137-140. The routing engine will also check this defaultrouting table, step 141, to see if there are any alternative outputengines specified, and if so, retrieve them step 142. The routing engine93 will also dispatch the information to any alternative destinationsspecified by the default routing rules. It does this by sending theinformation to the identified data output engine, e.g. 9 a, 94 b, step133, which converts the information to the recipient format, step 134and dispatches the information to the alternative recipient computersystem 18, step 135. A data output engine can be configured to dispatchinformation to more than one server.

Reminder Server

FIG. 11 is a flow chart showing operation of the reminder server 150.The reminder server receives the information uploaded to the remotecomputer system, step 151. The reminder server can determine how longhas passed since the last upload of information. If too long has passed,step 152, the reminder server generates a reminder that can becommunicated to the patient to ensure they upload the data from the CPAPmachine, step 153. The reminder server can also determine whether thepatient is complying with a treatment regime. Messages can becommunicated to the user to assist them to reach compliance. Thereminder and compliance message could be communicated in one of variousways. For example, it might be a recorded message/automated telephonecall, text message, email or similar via the PC, landline or mobiletelephone or other communications device. Alternatively, the patientmight receive a reminder/compliance message when they access the serviceprovider's website. Alternatively, a reminder/compliance message couldbe communicated to the CPAP machine and displayed to the user. Insteadof communicating with the remote computer system 15, the reminder server150 can communicate with a recipient computer system e.g. 19 a. Thereminder server contains and/or is coupled to and/or can control therequired hardware (e.g. telephone, computing device, transmission deviceand/or communications network or the like) to communicate the remindervia the desired means as mentioned above. There could be a separatereminder system for each mode of communication, or a single remindersystem that is configured to and/or contains operate required hardwareto communicate via any of the desired modes. In FIG. 2 a , the remindersystem is shown as a single entity for clarity purposes—but it will beappreciated that the configuration depicted is not necessarily theactual or only possible reminder system configuration.

The service provider or other appropriate party is able to configure ifa patient is to receive automated reminders, how they should receivethose reminders and the cycle at which they are to receive reminders.This is done when a patient is set up in the system. By default,preferably there are two reminder cycles available as follows.

-   -   Basic reminder cycle in which the reminder server 150 will        automatically contact (or facilitate contact) of the patient via        the selected contact methods (e.g. telephone, voice/text        message, email) at 7, 14, 30, 60 and 90 days (or other suitable        interval) to remind them to upload their clinical data.    -   Advanced reminder cycle in which the reminder server 150 will,        in addition to the contacts made in the basic cycle, contact a        patient at 180 days and 1 year (or other suitable interval) to        remind them to upload their clinical data.

The automated telephone call reminder system 150 is able to place anautomated phone call to a patient, at a scheduled time using thereminder server 150 controlling a telephone device. The calls arecalibrated based on a patient's time zone (selected when a patient iscreated in the system) to only place calls between a suitable hour, suchas between 8:00 am and 9:00 pm. When a call is answered, the remindersystem waits 2 seconds (or other suitable period) to determine if apatient or answering machine has answered the call. If an answeringmachine recording is detected to be triggered within that 2 secondwindow, a message is placed to remind the patient to upload the data attheir convenience. If the call is answered by a patient a recordinginstructs them to upload their data e.g. by inserting the memory cardfrom their CPAP apparatus, into an internet connected computer, andfollowing the onscreen instructions. Clearly, instructions provided willmatch the manner that it is expected the user will use to upload data.If the call is not answered by either a patient or answering machine,the system will try again for 3 consecutive days (or other suitableperiod.) If a data upload has been made within 2 days of a scheduledcall, the call will not be made. The reminder system 150 preferablyincludes a default voice for the telephone messages, although a providercan override this with their own recordings by uploading new voice audiofiles through a web interface.

The text message (e.g. SMS) reminder system 150 is able to place a textmessage to a patient's mobile device (e.g. cellular telephone) to remindthem to upload their clinical data. The text messages are calibratedbased on a patient's time zone (selected when a patient is created inthe system) to only occur between a suitable time, such as 8:00 am and9:00 pm. The default text message asks the user to upload their clinicaldata, and instructs them on how to do this. If a data upload has beenmade within 2 days of a scheduled text message, the call will not besent.

The system includes a default message for text messages; however aprovider can override this with their own message through a webinterface.

The E-mail message reminder system 150 is able to send an email messageto a patient to remind them to upload their clinical data. The defaultemail message asks the user to upload their clinical data, and instructsthem on how to do this. If a data upload has been made within 2 days ofa scheduled email, the email will not be sent. The system includes adefault message for e-mail messages; however a provider can overridethis with their own message through a web interface.

Other modes of communicating a reminder could be envisaged by thoseskilled in the art and the reminder server is not restricted to only thecommunication modes mentioned above. These are provided by way ofexample only.

The reminder system 150 may also be used to remind the patient aboutother events such as returning a modem (GSM or telephone) back to theirprovider. During a call the system may also be used to gain feedbackfrom the patient about how comfortable their treatment is, if they arehaving any treatment problems or if they would like to be personallycontacted by their healthcare provider.

What is claimed is:
 1. A breathing apparatus usage data capture computer system, the system comprising: a network interface, a memory device, and a computer system processor, the computer system processor configured to: one or both of receive data from or transmit data to a remote user computer via a network, wherein the computer system processor is configured to receive breathing apparatus usage data in response to the memory device containing the breathing apparatus usage data being connected to the remote user computer, wherein the memory device is configured to be electrically connected to a memory port of a breathing apparatus so as to retrieve the breathing apparatus usage data, the breathing apparatus further comprising a flow generator, one or more sensors, and a controller, and one or both of control or connect to communication hardware so as to send an electronic reminder message, the electronic reminder message configured to remind a user of the breathing apparatus to connect the memory device to the remote user computer.
 2. The breathing apparatus usage data capture computer system according to claim 1 wherein one or both of controlling or connecting to communication hardware so as to send the electronic reminder message further comprises: determining time lapsed since a last time the memory device was connected to the remote user computer; and generating the electronic reminder message in response to the time lapsed exceeding a threshold.
 3. The breathing apparatus usage data capture computer system according to claim 1 wherein the computer system processor is configured to send the reminder message at 7, 14, 30, 60, or 90 days after a user account for the user is set up in the system.
 4. The breathing apparatus usage data capture computer system according to claim 3 wherein the computer system processor is further configured to send the reminder message at one or both of 180 days or one year after the user account is set up in the system.
 5. The breathing apparatus usage data capture computer system according to claim 1 wherein the computer system processor is further configured to determine whether the user is complying with a treatment regime based on the breathing apparatus usage data received from the remote user computer.
 6. The breathing apparatus usage data capture computer system according to claim 5 wherein the computer system processor is further configured to generate an electronic compliance message in response to determining that the user is not complying with the treatment regime.
 7. The breathing apparatus usage data capture computer system according to claim 6 wherein the compliance message is configured to assist the user to reach compliance with the treatment regime.
 8. The breathing apparatus usage data capture computer system according to claim 1 wherein the remote user computer is configured to execute an application stored on the memory device to retrieve the breathing apparatus usage dat.
 9. A breathing apparatus usage data capture computer system according to claim 1 further comprising a webserver, wherein the remote user computer is configured to download an application from the webserver and execute the application to retrieve the breathing apparatus usage data further upon the user accessing a website provided by the webserver.
 10. The breathing apparatus usage data capture computer system according to claim 1 wherein the memory device is a portable device.
 11. The breathing apparatus usage data capture computer system according to claim 1 wherein the memory device is a USB memory device.
 12. The breathing apparatus usage data capture computer system according to claim 1 wherein the reminder message is communicated by way of: an automated telephone call or a recorded message; a facsimile message; an email or instant messaging; a text message; a message on a web interface of a web server in response to the user accessing the web interface; or a message communicated to the breathing apparatus and displayed on a user interface on the breathing apparatus.
 13. The breathing apparatus usage data capture computer system according to claim 1 wherein the communication hardware comprises: a telephone; a mobile communication device; a computing device; or a communications network.
 14. The breathing apparatus usage data capture computer system according to claim 1 wherein the computer system processor is further configured to communicate with a computing system of a service provider of the breathing apparatus to deliver the reminder message.
 15. The breathing apparatus usage data capture computer system according to claim 1 wherein the reminder message comprises a default message to ask the user to upload his or her breathing apparatus usage data.
 16. The breathing apparatus usage data capture computer system according to claim 15 wherein the default message further comprises instructions on how to upload the breathing apparatus usage data.
 17. The breathing apparatus usage data capture computer system according to claim 15 wherein the computer system processor is further configured to allow the default message to be overridden by a different electronic message received via a web interface, the different message provided by a service provider of the breathing apparatus.
 18. The breathing apparatus usage data capture computer system according to claim 1 wherein the computer system processor is further configured to calibrate sending of the reminder message based on the user's time zone.
 19. The breathing apparatus usage data capture computer system according to claim 1 wherein the computer system processor is further configured to generate a follow-up electronic reminder message in response to no connection of the memory device to the remote user computer within a predetermined number of days of sending of the reminder message. 